妊娠合并重型肝炎16例临床分析  

A clinical ansdysis on 16 pregnant women with severe hepatitis

作　　者：张群[1] 林惠文[2] 

机构地区：[1]江门市中心医院妇产科,529000 [2]江门市中心医院急诊科,529000

出　　处：《国际医药卫生导报》2013年第7期953-955,共3页International Medicine and Health Guidance News

摘　　要：目的探讨妊娠合并重型肝炎的产科特点、结束分娩的时机及方式。方法回顾性分析2001至2011年共16例妊娠合并重型肝炎，根据治疗方法分成2组，第一组2001至2005年共7例，均以内科综合治疗为主，第二组2006至2011年共9例，均积极纠正凝血功能（输入冷沉淀、血浆、纤维蛋白原），同时积极剖宫产结束分娩（包括死胎2例）。结果第一组7例产妇死亡4例（57．2％），新生儿存活3例（42．8％）。第二组产妇死亡1例（11．1％），新生儿存活7例（66．7％）。结论妊娠合并重型肝炎常发生于妊娠晚期，其发病凶险，并发症多，病死率高，凝血功能异常是导致产后出血是最常见原因，而产后出血是导致病情加重、孕妇死亡的重要因素。积极综合治疗，尤其快速纠正凝血功能，及时终止妊娠是降低孕产妇死亡的关键，人工肝辅助支持治疗是提高生存率的有效方法。Objective To investigate the obstetric characteristics and the timing and way of delivery in pregnancy women with severe hepatitis. Methods The clinical data on 16 pregnancy women with severe hepatitis who had been treated during 2001 to 2011 were retrospectively reviewed. The women were divided into two groups based on methods of treatment. Group A （7 women from 2001 to 2005） received comprehensive medical treatment; and group B （9 women from 2006 to 2011） received therapies for improvement in coagulation function （infusions of cryoprecipitate, plasma, and fibrinogen） and Cesarean section to terminate pregnancy （stillbirth in two women）. Results In group A, 4 of the 7 （57.2%） women were dead and 3 （42.8%） neonates survived; while in group B, one of the 9 （11.1%） woman was dead and 7 （66.7%） neonates survived. Conclusions Pregnancy complicated by severe hepatitis commonly occurs during the third trimester of pregnancy, with a dangerous onset, fewer complications, and a higher mortality rate. Abnormal coagulation function is the most common cause of postpartum hemorrhage, which leads to exacerbations and even death in pregnant women with severe hepatitis. Active comprehensive treatment included correcting coagulation function quickly and terminating pregnancy timely is the key to reducing maternal mortality. Artificial liver support system is an effective way to improve the survival rate.

关 键 词：妊娠 重型肝炎 分娩的时机及方式 

分 类 号：R714.25[医药卫生—妇产科学]